{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:17:03Z","timestamp":1761059823189,"version":"3.38.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2014,10,16]],"date-time":"2014-10-16T00:00:00Z","timestamp":1413417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> The Department of Health estimates that currently in the UK, 61.3% of the population are overweight or obese (BMI &gt;25 kg\/m<jats:sup>2<\/jats:sup>). Fistulae in the obese often fail to mature or prove inadequate to needle due to excessive depth (&gt;6 mm). This study is a summary of our experience with brachio and radio-cephalic vein superficialisation in the obese. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> From May 2008 to October 2012, 22 patients underwent superficialisation of the cephalic vein following radio-cephalic or brachio-cephalic Arterio-venous fistula (AVF) creation. Data were obtained from a prospective database (Cyberen<jats:sup>\u00ae<\/jats:sup>) and retrospectively analysed. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The study included 23 AVFs in 22 patients (seven males, 15 females), of which 13 were brachio-cephalic and 10 radio-cephalic. The mean age of the patients was 56 years (median 60, range 19-78 years). The mean BMI was 36.7 kg\/m<jats:sup>2<\/jats:sup> (median 32, 25-58 kg\/m<jats:sup>2<\/jats:sup>). Six-week post procedure duplex ultrasonography recorded the mean fistula depth to be 7.7 mm (median 8 mm, 5-15 mm) and mean flow rates were 961 ml\/min (median 800 ml\/min, 320-1968 ml\/min). Of the 23, 21 fistulae matured successfully. There were no procedure-related complications. During follow-up, two patients underwent transplantation prior to fistula use and three patients died of unrelated causes. The remaining 16 fistulae remain in use and under access surveillance. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Superficialisation of brachio\/radio-cephalic fistulae is an excellent option to optimise the cephalic vein for needling, assisting primary patency. Superficialisation of the cephalic vein helps maintain long-term functional access in overweight and obese patients. <\/jats:p><\/jats:sec>","DOI":"10.5301\/jva.5000307","type":"journal-article","created":{"date-parts":[[2014,11,3]],"date-time":"2014-11-03T09:24:51Z","timestamp":1415006691000},"page":"126-129","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Vascular access in the Obese: Superficialisation of Native Radio-Cephalic and Brachio-Cephalic Fistulae"],"prefix":"10.1177","volume":"16","author":[{"given":"Richard P.T.","family":"Evans","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, University Hospital of North Staffordshire, Staffordshire - UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lewis","family":"Meecham","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital of North Staffordshire, Staffordshire - 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